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<br />: CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject Lo "deed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CON'I'UAC'I'OR RESPONSIBILI'l'IES
<br />If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />188-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which they will be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />"
<br />11'..
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<br />D. CONSTRUCTION LIEN unw (ClmPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HDIeOIDer's Protection
<br />Guide~ prepared by the Florida Deparllent of Agriculture and ConsUler Affairs. If the applicant is sOleOne other than the
<br />"owner", I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
<br />"owner" prior to COllenCelent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'I'
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, laning, and land developlent.
<br />I \
<br />
<br />Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perf OIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction, I also
<br />certify that I understand that the regulations of other goverRlental agencies lay apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not 11lited to:
<br />t Departlent ot Environtental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Vater/Wastewater Treallent
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Vetland Areas, Altering Vatercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Deparllent of Health & Rehabilitative Services, BnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US BnviroDlental Protection Agency - Asbestos abateJent
<br />I also certify that, if fill laterial is to be used in Fiood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "colpensating volUle- will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit. issuance.
<br />
<br />. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall is~u~nce of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit i88ued shall beCOle invalid
<br />unless the work authorized by such perlit is cOllenced within sil IOnths of issuance, or if work authoriled by the petlit is
<br />suspended or abandoned for a period of six IOnths after the tile the wort is cOIIenced. One 90 day e1tension of tile,., be
<br />allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each Sil IOnth period, or the project will be considered abandoned.
<br />VARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCBHBNT HAY RHSULT IN YOUR PAYING TIIICH FOR IHPROVIIIDfS TO YOUR
<br />PROPHRTY. IF YOU INTHND TO OBTAIN FINANCING, CONSULT VITH YOUR LHNDHR OR AN ATTORNBY BBFORB RBCORDING YOUR NorlCl OF
<br />COHHENCEHENT~ JOBS UNDER $2,500 IN ~ NOT NEED TO RECORD AND POST A :NOTICE OF COHHBNCBHlNT".
<br />
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<br />d/~7~ --
<br />SIGNATURE: OWNER OR AGRNT
<br />
<br />
<br />, I
<br />
<br />STATE OF FLORID~
<br />COUNTY OF. Itl~!'b~~?,~
<br />The foregoing instrument was acknowledged
<br />before me this .3/:z.G,. , 19~ by
<br />
<br />to;U/~ ~. ~Z-
<br />who is personally known to me or who has
<br />produced ,:' }) L-
<br />as identification and who did/did not
<br />take an oathOvt4 1r};/~
<br />
<br />(Signature) F tJ.
<br />1'/N1Jr.~A/~ . /11~,,~ ~
<br />(Name Typed: Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATR OF FLQRfDA .
<br />COUNTY OF H' Ll<;. '-o~<.J\ h
<br />The foregoing instrument as acknowledged
<br />before me this ~, 19~ by
<br />
<br />W l LL ; 4-r"YJ F'. .011 z...
<br />who is personally known to me or who bas
<br />produced F t> )...
<br />as identification and who ~/did not
<br />
<br />t.k~th:&. 9Y/~
<br />(Signatur
<br />A.u~~ F. MI97V\ ~'--itL.CO
<br />(Name Typed, P inted or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~ ~' ANTHONY F. MANISCALCO
<br />~ ,
<br />I ~ MY COMMISSION' cc ~ \
<br />i~~. :*! 1londId~~ ~::......
<br />
<br />..';;.'J'J::J.,,_ ANTHONY F. MANISCALCO
<br />I:W:~ ':"'{;i MY COMMISSION' CC 608980
<br />~ : i EXPIRES: AprIl 18. 2001
<br />. '.. 80ndId 1bru Naluy PubIfc Undetwril8ra
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